I suppose this could be considered another entry in my ‘happiness’ series, but this comes from a very different angle. I just finished a flat-out fantastic article in the New Yorker called The Way We Age Now, by Atul Gawande. What Dr. Gawande did was summarize the steeply declining geriatric profession and link it to anecdotal evidence for necessary changes in medicine’s attitude towards geriatrics.

What geriatricians do—bolster our resilience in old age, our capacity to weather what comes—is both difficult and unappealingly limited. It requires attention to the body and its alterations. It requires vigilance over nutrition, medications, and living situations. And it requires each of us to contemplate the course of our decline, in order to make the small changes that can reshape it. When the prevailing fantasy is that we can be ageless, the geriatrician’s uncomfortable demand is that we accept we are not.

Further information from the article: after a prominent study in the Twin Cities showed the positive influence that geriatric medicine had in the area, the University of Minnesota responded: it closed its geriatrics division. They were losing money on it. In a different part of the article: particularly poignant was the story of a retired doctor who was a geriatrician, and who could expound upon his aging self using medical terminology and knowledge. His insight, though, was most profound in the simple explanations:

“I try to deliberately focus on what I’m doing, rather than do it automatically,” he told me. “I haven’t lost the automaticity of action, but I can’t rely on it the way I used to. For example, I can’t think about something else and get dressed and be sure I’ve gotten all the way dressed.” He recognizes that the strategy doesn’t always work. He sometimes told me the same story twice in a conversation.

At first blush, an article like this is tremendously depressing. At second and third blush … it reads the same way. I mean, we’re talking about the inexorable toll time takes on the human mechanism, to the point of our ability to think being removed/severely altered. Then, there’s the fact that the entire field dedicated to caring for the reality of aging is shrinking. The pay is below average. Nobody wants to go into that division of medicine: it isn’t glamorous (a sad, but I’m assuming accurate, line of reasoning by young doctors). That’s all pretty hard to read about.

I didn’t read any redemptive tone until the very conclusion of the piece, which I guess is appropriate, given the circumstances and scope of the issue. But that little twist got me thinking about what matters (and here you get the happiness tie-in). To some, as expressed in the comments from my last piece on this topic, these “important things for happiness” are obvious. But, when you start thinking about it, the longer perspective this article provides really makes you reconsider how you want to live your youth. My motivation to spend any significant amount of time in a drunken stupor has always been unusually low, but realizing that I’ll have decades of my elderly life where my brain function is impaired pushes me further away from the analogous situation in youth. And that’s my weakest example … think about all the things we can do when we’re young, that we lose with age: from literally running around to waking up without pain, from traveling to chewing without choking, from embracing those we love to playing an instrument.

This brings me to my last point, and the one that is hardest to illustrate. After seeing things through the long lens of time/age, some things I enjoy now seem unequivocally hollow and devoid of meaning. My habitual reading of gadget websites like Engadget has declined in recent months, but now I see excellent justification to eliminating my visits there completely. It just doesn’t seem to matter. A sign of depression would be if nothing seemed to matter, but here, it’s as if there are 1,000,000 other things that could replace that gadget browsing time lost … things that I could look back on and say “that was fun/fulfilling/right.” I think a former editor of one of those gadget websites summarizes things pretty well:

I gave up two years of my life writing about gadgets for this site. Waking up every morning at 5 AM, chewing up press releases to find the rare morsel of legitimate information, chasing down “hot tips” that ended up being photochops of iPods with reflections of genitals in the touchscreens.
…
And you guys just ate it up. … You broke the site, clogging up the pipe like retarded salmon, to read the latest announcements of the most trivial jerk-off products, completely ignoring the stories about technology actually making a difference to real human beings, because you wanted a new chromed robot turd to put in your pocket to impress your friends and make you forget for just a few minutes, blood coursing as you tremblingly cut through the blister pack, that your life is utterly void of any lasting purpose.

So, recently I have tended towards reading longer format pieces of real honest-to-goodness writing online. If I’m spending some time here, reading, why not learn something worth knowing? Or see something worth seeing? Or laugh about something that’s funny? (The last category covers a lot of inane videos online … but Mykala and I spent 20 minutes watching some poor soul try to complete a nigh-impossible mod of Super Mario Brothers, and I found that extremely fulfilling … mostly because I got to share it with her).

I’m not saying don’t have fun, or don’t watch junk TV … I’m saying it’s valuable to understand just how great youth is. It all lends impressive insight into the way that Merlin, from The Once and Future King lived. That is, backwards. As everyone got older, he became younger … at some point, he would live a youth completely informed by old age. Bringing a fraction of that sort of insight into our own salad days is a noble goal, indeed.

• Medicine
• Happiness
• Aging
• Mario
• Atul Gawande

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